儿童肱骨髁上骨折治疗方法与分析

目的对儿童肱骨髁上骨折的治疗方法进行研究，分析手法复位与切开复位两种治疗方法的优缺点并对比其临床疗效。方法选取于2012年1月-2013年4月由该院接收治疗肱骨髁上骨折的60例患者，根据其不同的治疗方法分为两组，观察组为手法复位，30例。对照组为切开复位，30例。对其治疗情况进行记录，并进行追踪调查。对受伤后肘关节功能的恢复情况、骨折愈合时间和是否出现畸形等情况进行记录分析，并阐述两种治疗方法的优缺点。结果利用手法复位的观察组的患儿其优良率达到了96．7％。而利用切开手术复位的对照组的患儿其优良率为96．6％。两组数据显示从伤后肘关节功能的恢复情况看，手法复位要优于手术复位。从畸形率和临床愈合时间来看，观察组出现畸形1例，占总人数的3．3％，对照组为2例，占总人数的6．6％，两组患儿经过比较，差异无统计学意义（P〉0．05）。采用手法复位的观察组其临床愈合时间为4—6周，采用切开手术复位的对照组其临床愈合时间为6～8周。观察组要优于对照组。结论根据上述调查显示和结果分析，对于儿童肱骨髁上骨折的治疗，最佳的方法应为手法复位。手法复位有利于患儿伤后肘关节功能的恢复，临床愈合时间短。除非患儿出现了血管神经损伤或是手法复位失败，从而选择切开复位手术治疗。

Analysis of the Treatment of Supracondylar Fracture of Humerus in Children

Objective To study the treatment of supracondylar fracture of humerus in children, analyze the advantages and disadvantages of two kinds of treatment methods, manual reduction and open reduction, and compare the clinical curative effect of them. Methods 60 cases of patients with supracondylar fracture of humerus admitted in our hospital from January, 2012 to April, 2013 were divided into two groups, the observation group and the control group.30 cases in the observation group were treated with manual reduction, and 30 cases in the control group were treated with open reduction. The treatment of the patients was recorded, and the patients were followed up. The elbow joint function recovery after injury,fracture healing time and whether any deformity occurred were recorded and analyzed, and the advantages and disadvantages of two treatment methods were elaborated. Results The excellent and good rate of the children in the observation group treated by manual reduction was 96.7%, and that of the children in the control group treated by open reduction was 96.6%.In terms of the elbow joint function recovery after injury, manual reduction was better than open reduction. There was 1 case of deformity occurred in the observation group, accounting for 3.3%,2 cases in the control group, accounting for 6.6%, the difference was not statistically significant（P〉0.05）. The clinical healing time of the observation group was 4 ~ 6 weeks,which was shorter than that,6 ~ $ weeks of the control group.Conclusion According to the results of the survey and analysis, for the treatment of supracondylar fracture of humerus in children, the best method is manual reduction, which is beneficial to the recovery of elbow joint function after injury, and the clinical healing time is short. Open reduction can be chosen unless the child has neurovascular injury or manual reduction is failed.